Individual
MICHELLE RENEE DIIORIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AT-C
Contact information
Practice address
1919 W US HIGHWAY 50, PUEBLO, CO 81008-1618
(719) 253-7102
(719) 253-7114
Mailing address
1919 W US HIGHWAY 50, PUEBLO, CO 81008-1618
(719) 253-7102
(719) 253-7114
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
120402109
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120402109
NATIONAL ATHLETIC TRAINERS' ASSOCIATION
CO
Enumeration date
03/15/2019
Last updated
03/15/2019
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